Organization
DIRNE HEALTH CENTERS, INC
Active
Parent organization
DIRNE HEALTH CENTERS INC
Other names
Heritage Health Homeless Program, Street Medicine Community Outreach
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIRNE HEALTH CENTERS INC
Authorized official
MIKE BAKER (CEO)
(208) 620-5200
Entity
Organization
Contact information
Practice address
2205 N IRONWOOD PL, COEUR D ALENE, ID 83814-2610
(208) 783-1267
(844) 807-3782
Mailing address
PO BOX 1387, HAYDEN, ID 83835-1387
(208) 620-5200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1378465
MEDICARE PART B
ID
Enumeration date
03/18/2015
Last updated
03/04/2025
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